Femur lengthening with monoplanar external fixator associated with locked intramedullary nail

Henrique Paradella Alvachian Fernandes, Danilo Gabriel do Nascimento Silva Barronovo, Fabio Lucas Rodrigues, Marcos Hono

This study aimed to demonstrate that the lengthening technique of an external fixator associated with locked intramedullary nail is an efficient method that decreases the duration of the external fixation and improves the rehabilitation period. From January of 2005 to May of 2014, 31 patients with mean lower limb discrepancy of 5.31 cm were treated. The etiologies of the deformity were femur fracture sequelae, infection, hip development dysplasia, polio, and congenital short femur. The mean duration of external fixation was 2.47 months (external fixation index of 16.15 days per cm). The mean time for bone healing was 6.66 months (consolidation index 43 days per cm). Initial mean knee range of motion was -1° to 100°, progressing to 0°-115° at the end of treatment. The complications observed were incomplete osteotomies, hip subluxation, broken fixator, decreased knee range of motion, and need for locking screw removal. Femur lengthening with a monoplanar external fixator associated with locked intramedullary nail allowed for a shorter period of external fixation use, better protection for the regenerated bone tissue, and early rehabilitation with possible complications.